Brady Eikleberry will be a year old on Saturday. His entire life, he has been a patient at Children's Hospital Medical Center of Akron. He is also a perfect example of the cost of inflexibility in the Medicaid bureaucracy.

Brady has had several difficult surgeries to repair two holes in his heart and defects in his esophagus and trachea. His doctors and nurses say he is ready to go home.

But Brady is caught in the mesh of state Medicaid policies and likely will remain at the hospital for a good while longer.

His medical expenses have exhausted his parents' insurance benefits -- his mother's $1 million lifetime benefit and his father's $25,000 annual coverage. His care at Children's is paid by a special Medicaid program that covers institutional care when the costs exceed certain levels. Brady's intensive-care charges alone exceed $68,000 a month.

For Medicaid to pay for his care at home, Brady must be enrolled in a different program, the Ohio Medicaid Home Care Waiver. Home-care charges? About $20,000 a month. The trouble is, slots for the program are limited, and more than 3,000 people are on the waiting list ahead of him.

There are no compelling reasons why Brady should remain in the hospital for another day, week or month. He will need nursing care about 16 hours a day and use a ventilator until he is at least 2 years old, but his doctors and nurses believe that he will be better off developmentally in a home environment. His parents also are eager to have him home in Steubenville.

The state Medicaid office recently denied his parents' appeal for a waiver slot. The Eikleberrys cannot afford to pay the cost of his care on their own, and their income is too high for the family to be eligible for regular Medicaid coverage.

So Brady remains at Children's.

If any reason should persuade the state to let the Eikleberrys take their baby home, it should be the economic trade-off. Home care is a fraction of the cost of keeping Brady in an institution, whether at Children's or a long-term care facility.

The waiting period for the home-care program is anywhere from six months to a year or more. Send the baby home and save? Few things are that simple about the Medicaid bureaucracy. The state continues to pay thousands of dollars a month while the baby is in the hospital.

Certainly, it would be unfair to bump Brady up ahead of others on the waiting list. The problem, however, is not fairness. The problem is sticking inflexibly to policies even when they defy economic logic.

Gov. Bob Taft's proposed budget has put the ax to a number of programs to cut Medicaid expenses. The budget plan would eliminate vision and dental care for poor adults and freeze reimbursement rates to children's hospitals and doctors, among other measures.

There is no explaining the absurdity. If the 3,000-plus cases waiting for waivers are racking up bills like Brady's, where is the logic in passing up less expensive home care?